Prevalence of COVID-19 Vaccine Hesitancy in South Asia: A Systematic Review and Meta-Analysis

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Mohammad Mainul Islam
Md. Yeasir Yunus
Muhammad Saifullah Akib
Md. Rakibul Iqbal
Mohona Khan


Vaccine uptake and coverage in susceptible populations are needed through effective vaccination campaigns to address the COVID-19 pandemic in South Asian countries. We aimed to measure the pooled proportion of COVID-19 vaccine hesitancy in this regard. Research articles published between January 1, 2020, to December 31, 2021, were searched through Medline, PubMed, Cochrane, Google Scholar, and the WHO COVID-19 database. The Joanna Briggs Institute (2014) tool for prevalence studies was used to assess data quality. We performed a meta-regression test and a sensitive analysis among the studies and used the DerSimonian and Laird random-effects model to measure the pooled effect estimates. Subgroup analyses were performed concerning vaccine hesitancy, countries, study population, study level, and the time since the first outbreak of the pandemic. A total of 43 studies out of 598 published articles across the eight countries in South Asia were included. The pooled proportion of COVID-19 vaccine hesitancy was 26.5% (95% CI [22, 31], I2 = 99.59%). Vaccine hesitancy was higher in Afghanistan (37%), Pakistan (33%), and Bangladesh (28.9%); among the general population (29%); at community levels (27.9%); and the duration of time of 1–12 months since the first outbreak in each country (27.5%). Vaccine hesitancy exists in South Asia with different rates among countries, population sub-groups, communities, study- levels, duration of time since the first outbreak, and study population. Therefore, enhancing public awareness of vaccination and vaccine hesitancy is required to prevent future pandemics.


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Islam, M. M., Yunus, M. Y., Akib, M. S., Iqbal, M. R., & Khan, M. (2023). Prevalence of COVID-19 Vaccine Hesitancy in South Asia: A Systematic Review and Meta-Analysis. Journal of Population and Social Studies [JPSS], 31, 587–611. Retrieved from
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Mohammad Mainul Islam, Department of Population Sciences, University of Dhaka, Bangladesh

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